Anti-Acne Flashcards
Common dermatological disorder of the pilosebaceous unit
Acne
T/F: Acne is a disease condition
True
Major contributing factors to acne development
Sebum
Androgenes
Hyperkeratinization
P. acnes
Inflammation, immune reactions
T/F: Usually acne is in part triggered by excess sebum production
True
Main causative agent associated with acne development
Propionibacterium Acnes
What stage in Acne Pathogenesis: Hyperkeratosis and Increase corneocyte cohesiveness in the upper sebaceous follicle which lead to microcomedo formation
Early Comedo
What stage in Acne Pathogenesis: Microcornedo
Early Comedo
What stage in Acne Pathogenesis: Accumulation of shed keratin and sebum
Later comedo
What stage in Acne Pathogenesis: Formation of whorled lameliar concretions
Later comedo
What stage in Acne Pathogenesis: Comedo may be closed or open
Later comedo
What stage in Acne Pathogenesis: Propionibacterium acnes proliferation, which upregulates innate immune responses
INFLAMMATORY PAPULE/PUSTULE
What stage in Acne Pathogenesis: Mild inflammation (primarily neutrophils), which increases upon rupture of the comedo wall
INFLAMMATORY PAPULE/PUSTULE
What stage in Acne Pathogenesis: Sebaceous lobule regression
INFLAMMATORY PAPULE/PUSTULE
What stage in Acne Pathogenesis: Marked inflammation (primarily T cells)
NODULE/CYST
What stage in Acne Pathogenesis: May lead to scarring
NODULE/CYST
Types of Acne: Blackheads and White Heads
Non-inflammatory lesions
Consists of open and closed comedones, which are not inflamed and red because follicle walls are intact
Non-inflammatory lesions
Known as open comedones
Blackheads
Follicles that have wider opening filled with sebum and dead cells
Blackheads
Dark colors in Blackheads are caused by exposure of the top of the comedo to _________
oxygen
Known as closed comedones
Whiteheads
Follicles opening is closed and have normal skin color
Whiteheads
More likely to progress into inflammatory lesion
Whiteheads
Closed comedo becomes larger and packed due to debris and inflammation from P. acnes.
Inflammatory lesions
In Inflammatory lesions; follicle ruptures, white blood cells and red blood cells migrate to contain rupture, and lesions turn ___________.
red
Primary inflammatory lesions; small, raised, usually red, and tender bumps under the skin
Papules
Also called pimple; red tender bumps with white pus at the tip
Pustules
Deep lesions that are hard to touch, more painful, and deep red or purple of in color
Nodule
Large pus-filled lesions resulting from severe inflammatory reaction
Cyst
Can result to scarring of acne
Cyst
limited to face, and characterized by presence of non-inflammatory closed and open comedones with few inflammatory lesions
Mild acne
increased number of inflammatory papules and pustules on the face and affects other body parts
Moderate acne
back, chest, shoulders acne
Moderate acne
presence of nodules and cysts; facial lesions accompanied by widespread disease on the neck, chest, and back
Severe acne
Acne topical treatments
Benzoyl peroxide (BPO)
Salicylic acid
Resorcinol and Sulfur
Topical Retinoids
Topical Antibiotics
Azelaic Acid
Non-antibiotic antimicrobial agent that kill bacteria by producing reactive oxygen species within clogged pores
Benzoyl peroxide (BPO)
Increases cell turnover, cleans pores, desquamates skin, and has anti-inflammatory properties.
Benzoyl peroxide (BPO)
This topical treatment also addresses hyperkeratinization
Benzoyl peroxide (BPO)
Mainstay treatment of mild to moderate acne, in combination with antibiotics and/or retinoids
Benzoyl peroxide (BPO)
SE of BPO
peeling, dryness, burning, and redness of the skin
T/F: We must also use sunblock together with using BPO
True
In BPO, Irritation resolves with continued use during ____________ of treatment
1st month
Betahydroxy acid
Salicylic acid
Desquamating and comedolytic properties
Salicylic acid
Less potent and better tolerated than topical retinoids
Salicylic acid
Salicylic acid are _________ products at concentrations of ________ as lotions, creams, ________, facial wash gels, ________, and ___________
OTC; 0.5-2%; foams; toners; cleansing pads
Salicylic acid SE:dryness, redness, ___________, ________, and burning
scaling;itching
T/F: The use of salicylic acid must be coupled with the use of sunblock/sunscreen
True
Available as creams, masks, ointments, and soap bars
RESORCINOL AND SULFUR
T/F: Sulfur has antibacterial effects
True
Topical Retinoids are____________ derivatives that normalize abnormal desquamation in sebaceous follicles, ______________ coherence of follicular keratinocytes, and prevent formation of new ___________________
Vitamin A; decrease; microcomedones
Maybe used as monotherapy for the management of mild noninflammatory comedonal acne with maximum benefit after 3-4 mos., and as maintenance therapy
Topical retinoids
Include tretinoin, adapalene, tazarotene
Topical retinoids
Topical retinoids are available as:cream, gel, _________, and ____________ formulations
liquid; microsphere
Topical retinoids SE:___________, burning sensation, redness, itching, and ___________
transient skin irritation, burning sensation, redness, itching, and peeling
Negative effects of topical retinoids can be prevented by using _______________ of active ingredients or _______________
lower concentration; modifying the vehicle
Used for mild or moderate acne with inflammatory lesions
Topical antibiotics
Include clindamycin and erythromycin
Topical antibiotics
With bacteriostatic and anti-inflammatory properties
Topical antibiotics
Topical antibiotics are available as:gels, creams, _________, _________, _______, and _______
gels, creams, lotions, foams, toners, and pads
topical antibiotics are combined wtih
BPO and Retinoids
Alternative to retinoids; with comedolytic, antimicrobial, and anti-inflammatory properties
Azelaic Acid
Part of the annex that list the ingredients that are not allowed for use in cosmetics
Azelaic Acid
Systemic treatments
Oral Antibiotic
Hormonal Therapy
Isortetinoin
Include doxycycline, minocycline, tetracycline, and erythromycin
Oral Antibiotic
May cause upset stomach, dizziness, or skin discoloration
Oral Antibiotic
antibiotic that may cause sun sensitivity
Doxycycline
oral antibiotic that can cause teeth discoloration
tetracycline
oral antibiotic that can cause skin hyperpigmentation
minocycline
Adjunct therapy in women with moderate to severe acne
hormonal therapy
Reduces and/or prevents outbreaks, but not effective for existing lesions (used with topical retinoids for lesions)
hormonal therapy
Hormonal Therapy Forms:
(1) Combination ** oral contraceptives suppress ovarian androgen production** , and
(2) ** Androgen receptor blockers block effect of androgen**s on the sebaceous gland (spironolactone, cyproterone, and flutamide)
May cause headache, breast tenderness, nausea and depression; increased risk of heart disease, high blood pressure, and blood clots
hormonal therapy
Oral retinoid for the treatment of moderate to severe acne that does not respond to other treatments
Isoretinoin
Targets all major components in acne development, and may be used as monotherapy
Isoretinoin
May cause dryness of the skin, eyes, mouth, lips, and nose; itching; nosebleeds; muscle aches; sun sensitivity; and poor night vision
Isoretinoin
May increase levels of triglycerides and cholesterol in the blood, and increase liver enzyme levels
Isoretinoin
May cause malformation of developing fetus (teratogenic)
Isoretinoin
has moderate growth inhibitory and bactericidal effect on Propionibacterium acnes
Glycolic acid
squeezing with fingertips and using a comedone extractor
Comedo extraction
Include broad-spectrum continuous-wave visible light, intense pulsed light, pulsed dye lasers, photodynamic therapy (PDT), and pulsed diode laser
optical therapies
dietary restrictions
oily food, nuts, chocolates, dairy
T/F: Efficacy of dietary restrictions as acne treatment is questionable
True
